Enhanced Treatment Selection for Reflective Joint Cracking in Composite Pavements

This research developed a decision-making process that can be used by INDOT to enhance identification of the condition of the underlying concrete joints or cracks by looking at the surface distresses of the asphalt overlay in composite pavements. In order to achieve the research objective, several tasks were performed during the research including literature reviews, data collection, and data analysis. In conjunction with the developed decision-making process, this study also developed a databased to organize the collected data and a computer application to not only increase the accessibility of INDOT field engineers to the sample data but also to improve the analysis process by providing better visualization tools. The data collection was performed based on four steps of field evaluation procedure (visual inspection of asphalt overlay, FWD testing, Coring, and visual inspection of exposed concrete). The collected data was analyzed to show distribution of joint and mid-panel cracks, and correlation between asphalt crack severity and concrete crack severity. Four input factors from the analyzed data (visual inspection of asphalt overlay, D1, LTE, and Resilient Modulus) were selected to develop the decision-making tool. A handbook is also provided to help INDOT field engineers’ decision-making during their field activities. The handbook contains important information of pavements, photographs of cracks, and the exposed concrete condition of sample data points for the benefit of field engineers. Recommendations and limitations are also discussed in this report

Unleashing the full potential of Hsp90 inhibitors as cancer therapeutics through simultaneous inactivation of Hsp90, Grp94, and TRAP1

Cancer therapeutics: Extending a drug's reach A new drug that blocks heat shock proteins (HSPs), helper proteins that are co-opted by cancer cells to promote tumor growth, shows promise for cancer treatment. Several drugs have targeted HSPs, since cancer cells are known to hijack these helper proteins to shield themselves from destruction by the body. However, the drugs have had limited success. Hye-Kyung Park and Byoung Heon Kang at Ulsan National Institutes of Science and Technology in South Korea and coworkers noticed that the drugs were not absorbed into mitochondria, a key cellular compartment, and HSPs in this compartment were therefore not being blocked. They identified a new HSP inhibitor that can reach every cellular compartment and inhibit all HSPs. Testing in mice showed that this inhibitor effectively triggered death of tumor cells, and therefore shows promise for anti-cancer therapy. The Hsp90 family proteins Hsp90, Grp94, and TRAP1 are present in the cell cytoplasm, endoplasmic reticulum, and mitochondria, respectively; all play important roles in tumorigenesis by regulating protein homeostasis in response to stress. Thus, simultaneous inhibition of all Hsp90 paralogs is a reasonable strategy for cancer therapy. However, since the existing pan-Hsp90 inhibitor does not accumulate in mitochondria, the potential anticancer activity of pan-Hsp90 inhibition has not yet been fully examined in vivo. Analysis of The Cancer Genome Atlas database revealed that all Hsp90 paralogs were upregulated in prostate cancer. Inactivation of all Hsp90 paralogs induced mitochondrial dysfunction, increased cytosolic calcium, and activated calcineurin. Active calcineurin blocked prosurvival heat shock responses upon Hsp90 inhibition by preventing nuclear translocation of HSF1. The purine scaffold derivative DN401 inhibited all Hsp90 paralogs simultaneously and showed stronger anticancer activity than other Hsp90 inhibitors. Pan-Hsp90 inhibition increased cytotoxicity and suppressed mechanisms that protect cancer cells, suggesting that it is a feasible strategy for the development of potent anticancer drugs. The mitochondria-permeable drug DN401 is a newly identified in vivo pan-Hsp90 inhibitor with potent anticancer activity

Two Cases of Hypertensive Encephalopathy Involving the Brainstem

Hypertensive encephalopathy is a medical emergency whose clinical manifestations are usually associated with bilateral parieto-occipital lesions. Predominant brainstem edema without accompanying occipital lesions is rare in hypertensive encephalopathy and usually occurs in patients with secondary hypertension. We describe the clinical and radiological features of two patients with reversible hypertensive brainstem encephalopathy. Both patients had chronic renal failure, but the extensive neuroimaging abnormalities revealed few clinical features of brainstem involvement. The clinical findings and neuroimaging abnormalities resolved once the hypertension was treated

Myasthenia Gravis Appearing After Thymectomy: a Case Report and Review of the Literature

A small proportion of thymoma patients without myasthenia gravis (MG) have been observed to develop MG after total removal of the thymoma. However, the underlying cause is not yet known due to the rarity of postoperative MG patients. We report a 39-year-old man in whom MG appeared after surgical removal of a thymoma. Computed tomography and magnetic resonance imaging showed no signs of recurrent or metastatic thymoma. Administration of pyridostigmine bromide resulted in the prompt improvement of myasthenic symptoms. Our observations indicate that postoperative follow-up care with monitoring of possible postoperative MG is necessary after resecting a thymoma

New Concept of a Surgical Hospitalist: Early Experience of Managing the Admission, Critical Care, Trauma Surgery Team

The demand for hospitalists is increasing due to decreasing numbers of clinical residents and increased concerns regarding patient safety. However, several limitations in the surgical hospitalist role exist. The personnel of the surgical hospitalist, rapid response team (RRT), surgical critical care, and trauma surgery teams were unified under the admission, critical care, and trauma surgery (ACTs) team at this institution. The ACTs target are patients with severe disease not undergoing general postoperative course, or patients with the potential for severe conversion. Two surgical intensivists are on duty once a week and oversee the intensive care unit (ICU), the back-up treatment of critically ill patients, and the immediate treatment of trauma patients. ACTs also participate in the surgical RRT and select patients with a high probability of severe exacerbation. Between 2019–2021, the cardiopulmonary resuscitation incidence per 1,000 hospitalized patients in the surgical department decreased significantly from 0.81 to 0.55. From March to December 2021, the ACTs team were involved with 101 of 158 surgical patients admitted to the ICU: 62 with postoperative status, 29 with severe trauma, and 10 transferred to the ICU via RRT screening. Based on our experience, the role of the ACTs team can help improve patient safety

Federated Learning with Diffusion Models for Privacy-Sensitive Vision Tasks

Diffusion models have shown great potential for vision-related tasks, particularly for image generation. However, their training is typically conducted in a centralized manner, relying on data collected from publicly available sources. This approach may not be feasible or practical in many domains, such as the medical field, which involves privacy concerns over data collection. Despite the challenges associated with privacy-sensitive data, such domains could still benefit from valuable vision services provided by diffusion models. Federated learning (FL) plays a crucial role in enabling decentralized model training without compromising data privacy. Instead of collecting data, an FL system gathers model parameters, effectively safeguarding the private data of different parties involved. This makes FL systems vital for managing decentralized learning tasks, especially in scenarios where privacy-sensitive data is distributed across a network of clients. Nonetheless, FL presents its own set of challenges due to its distributed nature and privacy-preserving properties. Therefore, in this study, we explore the FL strategy to train diffusion models, paving the way for the development of federated diffusion models. We conduct experiments on various FL scenarios, and our findings demonstrate that federated diffusion models have great potential to deliver vision services to privacy-sensitive domains